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Medicine Year 4 > ENT > Flashcards

ENT Flashcards

1
Q

What might uvula deviation indicate in tonsillitis?

A

Peritonsillar abscess (quinsy)

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2
Q

First and second line treatment for otitis externa

A

First: Topical aceitic acid spray
Second: Topical combination steroid and antibiotic drops (if hearing loss)

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3
Q

What does bilateral purple swelling of the nasal septum indicate and how is it managed?

A

Septal haematoma

Urgent ENT review

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4
Q

Sudden onset vertigo, hearing loss and tinnitus after a viral infection with horizontal nystagmus and nausea/vomiting

A

Labyrinthitis

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5
Q

Unilateral tonsillar swelling and fever

A

Quinsy

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6
Q

Pharyngitis and Tonsillitis with splenomegaly

A

Infectious mononucleosis

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7
Q

Which antibiotics are avoided in EBV

A

penicillin

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8
Q

Tonsils which meet in the middle and are covered by a white film that bleeds when you attempt to remove it

A

Acute bacterial tonsillitis

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9
Q

Episodes lasting 20min of unilateral tinnitus, sensioneural hearing loss and vertigo with a ‘full’ sensation

A

Meniere’s disease

Acoustic neuroma is similar but more progressive

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10
Q

Bilateral conductive hearing loss and tinnitus with a FHx

A

Otosclerosis

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11
Q

2 year old with frequent otitis media and delayed speech

A

Glue ear (otitis media with effusion)

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12
Q

Management of a simple perforated eardrum

A

Reassure and follow up in 6 weeks

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13
Q

Define otalgia

A

Ear pain

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14
Q

ABx of choice for otitis media

A

Amoxicillin

clarithroymycin/erythromycin if allergic

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15
Q

Sudden onset vertigo WITHOUT hearing loss after a viral illness

A

Vestibular neuronitis

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16
Q

Management of an auricular haematoma

A

Same day ENT assessment

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17
Q

5 causes of drug ototoxicity

A

Aminoglycosides, furosemide, aspirin, cytotoxic drugs, NSAIDs

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18
Q

80 year old with sensioneural hearing loss at high frequencies

A

Presbycusis

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19
Q

Hx of unilateral vertigo and hearing loss with an absent corneal reflex

A

Acoustic neuroma

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20
Q

What condition is associated with bilateral acoustic neuroma

A

Neurofibromatosis type 2

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21
Q

Define exostosis

A

Benign bony growth (conductive hearing loss)

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22
Q

Management of unilateral polyp

A

Red flag for nasopharyngeal cancer - urgent referral to ENT

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23
Q

First line management of bilateral polyp

A

Topical corticosteroid therapy

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24
Q

Treatment of Ramsay Hunt Syndrome

A

Oral aciclovir and corticosteroids

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25
What is Ramsay Hunt Syndrome?
Herpes zoster oticus Auricular pain progressing to a vesicular rash around the ear, tinnitus and vertigo. ?Facial nerve palsy
26
4 features of mastoiditis
Persistent earache, conduction deafness, profuse discharge and posterior auricular tenderness
27
Management of mastoiditis
Refer urgently for IV ABx
28
Cause of the majority of sudden onset sensioneural hearing loss
Idiopathic
29
Risk factor for otosclerosis
Pregnancy
30
Management of vestibular neuronitis
Prochlorperazine in the ACUTE phase (only for a few days) | Then vestibular rehabilitation
31
Following referral to ENT, how are patients with sudden onset sensorineural deafness treated?
high-dose oral corticosteroids
32
Interpretation of Rinne and Weber
Rinne result: Air conduction > bone conduction bilaterally | Weber result: Lateralises to unaffected ear
33
Which nerve palsy is associated with sarcoidosis?
Sarcoidosis
34
6 associations with nasal polyps
``` asthma (particularly late-onset asthma) aspirin sensitivity infective sinusitis cystic fibrosis Kartagener's syndrome Churg-Strauss syndrome ```
35
Does MND and MS cause vertigo?
MND: No MS: yes
36
Management of a mouth ulcer for greater than 3 weeks
2 ww to oral surgery
37
Biggest risk factor for malignant otitis externa
Diabetes
38
Management of unilateral middle ear effusion in an adult
2ww to ENT | Nasopharyngeal cancer
39
What is Ludwigs angina?
Cellulitis at the floor of the mouth | Risk in immunocompromised patients with poor dentition
40
Treatment of otitis externa in diabetics
Ciprofloxacin to cover pseudomonas
41
Where is little's area
Anterior nasal septum
42
When do you treat sinusitis and what do you treat it with?
After 10 days: phenoxymethylpenicillin and intranasal steroids/decongestant
43
What is the most important part of the tympanic membrane to visualise in a patient with purulent ear discahrge
Attic | Cholesteatoma
44
Treatment for a perforated eardrum that does not resolve spontaneously
Muringoplasty
45
Bilateral high-frequency hearing loss
Presbycusis
46
Globus (feeling of a lump in the throat), hoarseness and no red flags
Laryngopharyngeal reflux
47
dysphagia, halitosis and regurgitation of undigested food with a mass below the sternocleidomastoid
Pharyngeal pouch
48
sensation of a lump being stuck in the throat, with no physical findings present
Globus hystericus
49
When would you treat otitis media with supportive care verus antibiotics
ABx if ear pain and bilateral sx in a child under 2 | Systemically unwell child needs ABX
50
Room spinning for 10 seconds when moving the head | Some nausea, no vomiting, hearing loss or tinnitus
Benign paroxysmal positional vertigo
51
Diagnosis and treatment of BPPV
Diagnosis: Dix-Hallpike manoeuvre (rotatory nystagmus) Treatment: Epley manoeuvre
52
Management of worsening stridor in post-op neck surgery
Urgent removal of sutures and call for senior help
53
smooth, fluctuant, non-tender unilateral mass that does not transilluminate located anterior to the sternocleidomastoid muscle
Branchial cyst
54
Red flag nosebleeds
Recurrent and unilateral
55
Is coughing a red flag for nosebleeds
No
56
ABx for tonsillitis
Phenoxymethylpenicillin for 10 days
57
What is sialadenitis
Inflammation of the salivary gland
58
Where are the 3 salivary glands found?
the parotid glands are anterior and inferior to each ear the submandibular glands lies below the angle of the jaw the sublingual glands lie beneath the tongue
59
Chronic cough and peristent headache
Sinusitis
60
Pain above and lateral to the eye
Temporal arteritis
61
Shooting pain across the face worse when you touch it
Trigeminal neuralgia
62
Age of onset of otosclerosis
20-40
63
Ear pain, epitaxis and cervical lymphadenopathy
Nasopharyngeal carcinoma
64
What is rhinitis medicamentosa and how is it treated?
Rebound nasal congestion brought on by extended use of topical decongestants Treated by stopping the decongestant
65
swelling in the subcutaneous tissue of the posterior triangle which transilluminates
Cystic hygroma
66
midline cyst which moves up on tongue protrusion and does NOT transilluminate
Thyroglossal cyst
67
Most common bacterial cause of otitis media
Haemophilus influenzae
68
Management of all post-tonsillectomy haemorrhages
Refer immediately to ENT If within hours then arrange immediate return to theatre If a few days later then commonly associated with wound infection (IV ABX)
69
Failure of all emergency management for epistaxis
Ligation of the sphenopalatine artery in theatre
70
Management of acute sensorineural hearing loss
Urgent ENT assessment for audiology and brain MRI
71
What is tachyphylaxis
progressive decrease in response to a given dose
72
Treatment of epistaxis from an anterior bleeding source that is visualized
Silver nitrate cautery
73
Remember that a goitre is a thing for neck lumps that move on swallowing
74
Common tumour of the parotid gland
Pleomorphic adenoma
75
Examination of menieres
Nystagmus and positive rombergs test
76
Unilateral symptoms in chronic rhinosinusitis
Referral to ENT
77
Recurrent ear discharge
Cholesteatoma
78
Treatment for chronic sinusitis
Nasal irrigation with saline solution
79
Sudden onset dizziness with headache and difficulty walking
Cerebellar stroke
80
What infection is tonsillar SCC associated with
HPV infection
81
pain on palpation of the tragus, itching, discharge and hearing loss
Otitis externa
82
Age of presentation of cholesteatoma
10-20 years
83
What increases the risk of cholesteatoma
Cleft palate
84
Naseptin (chlorhexidine/neomycin) cream contains peanut oil
85
Complication of thyroid surgery
Damage to parathyroid glands can result in hypocalcaemia causing QT elongation
86
Elderly patient dizzy on extending neck
Vertebrobasilar ischaemia
87
Menieres prevention and treatment
Prevention: betahistine Treatment: prochlorperazine
88
Treatment of quinsy
IV ABx and surgical drainage
89
What type of hearing loss is noise related hearing loss
Sensorineural
90
5 causes of gingival hyperplasia
phenytoin, ciclosporin, calcium channel blockers and AML
91
management of acute necrotizing ulcerative gingivitis (halitosis, mouth pain and ulceration) with fever
Paracetamol + Oral metronidazole + Chlorhexidine mouthwash
92
Samter's triad
asthma + aspirin sensitivity + nasal polyposis
93
Medication to avoid in asthma
Beta blockers Aspirin NSAIDs
94
Slow growing, painless, mobile lump in the parotid gland of older female
Pleomorphic adenoma
95
first-line treatment for impacted ear wax
olive oil drops
96
Management of spreading erythema after otitis externa
Oral flucloxacillin
97
Management of Ludwigs Angina
999 immediate transfer to hospital
98
Persistent unexplained hoarseness in a patient aged >45 years old
Urgent referral to ENT and CXR
99
Adults are generally required to have had a failed trial of hearing aids before having a cochlear implant
100
Management of children presenting with glue ear with a background of Down's syndrome or cleft palate
ENT referral
101
Child under 2 with otitis media
Prescribe abx if bilateral
102
otitis media with perforation
ABx
103
Management of pleomorphic adenoma
Routine surgical removal due to risk of malignant transformation
104
Metastatic SCC in cervical lymph node | Most likely primary site
Nasopharynx

Medicine Year 4 (13 decks)

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